高齢者における下腹部手術の鼠径部ヘルニア発症に対する影響

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  • INFLUENCE OF LOWER ABDOMINAL SURGICAL PROCEDURES ON THE ONSET OF INGUINAL HERNIA

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One hundred and forty-six patients with inguinal or femoral hernia who were over 60 years old treated at the department in a past 8-year period were studied in terms of previous history of other abdominal surgical procedures. There were 102 sites with external inguinal hernia, 25 with internal inguinal hernia, 22 with femoral hernia and 3 with pantaloon hernia. Forty patients had received some other abdominal surgical procedure previously in 45 sites, before repair of inguinal or femoral hernia. In these patients, upper median incision was performed in 9 patients, lower median incision in 18 and appendectomy in 19. In the lower median incision group (n=18), prostatic operation was done in 13, bladder operation in 2 and uteric operation in 3 patients.<br> Compared with randomly sampled 146 patients as control who were admitted to the internal department at our hospital, a significantly high frequency of history of urological operations with lower median incision was noted in hernia group. In 15 inguinal hernia patients undergoing urological operation (one patient had bilateral hernias), 15 hernias were external inguinal hernia. And additionally, in the patients undergoing urological operation, the mean time from previous operation to the onset of the hernia was 32 months. This duration was significantly shorter than that in patients undergoing other abdominal surgical procedures.<br> It is suspected that urological operation may injure valvular action of the internal inguinal ring which causes external inguinal hernia. Therefore, meticulous attention should be in mind for lower abdominal surgical procedures.

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